Urticaria can be a chronic and debilitating affliction and is a relatively common disorder affecting between 10-
20% of the population. Common causes include reactions to medication, food allergen, physical stimuli and venoms.
Urticaria can be acute or chronic. Chronic urticaria lasts for more than 6 weeks and is commonly difficult to treat. The use
of immunosuppressive agents for this disorder when antihistamines fail can result in significant morbidity. Recent
advances in the pathogenesis, etiology, diagnosis and management of chronic urticaria have led to new paradigms in
treatment of this disorder. Cyclosporine is often the most effective but has some unique adverse effects that may prevent it
from being used in some patients. The use of intravenous immunoglobulin (IVIG) has proven effective in a variety of
reports and we will review the mechanisms likely involved in the successful control of urticarial symptoms by
immunomodulating therapy using IVIG. In this review, we will discuss mechanisms and pathogenesis of urticaria and the
specific role of intravenous immunoglobulin (IVIG) in this disorder, especially in refractory or steroid-dependent cases.
Keywords: Antibody, autoimmune, chronic urticaria, immunoglobulin, intravenous, urticarial, vasculitis, IVIG, Cyclosporine, angioedema.
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